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Background: Network meta-analysis (NMA) has become a popular method to compare more than two treatments. This scoping review aimed to explore the characteristics and methodological quality of knowledge synthesis approaches underlying the NMA process. We also aimed to assess the statistical methods applied using the Analysis subdomain of the ISPOR checklist.Methods: Comprehensive literature searches were conducted in MEDLINE, PubMed, EMBASE, and Cochrane Database of Systematic Reviews from inception until April 14, 2015. References of relevant reviews were scanned. Eligible studies compared at least four different interventions from randomised controlled trials with an appropriate NMA approach. Two reviewers independently performed study selection and data abstraction of included articles. All discrepancies between reviewers were resolved by a third reviewer. Data analysis involved quantitative (frequencies) and qualitative (content analysis) methods. Quality was evaluated using the AMSTAR tool for the conduct of knowledge synthesis and the ISPOR tool for statistical analysis.Results: After screening 3538 citations and 877 full-text papers, 456 NMAs were included. These were published between 1997 and 2015, with 95% published after 2006. Most were conducted in Europe (51%) or North America (31%), and approximately one-third reported public sources of funding. Overall, 84% searched two or more electronic databases, 62% searched for grey literature, 58% performed duplicate study selection and data abstraction (independently), and 62% assessed risk of bias. Seventy-eight (17%) NMAs relied on previously conducted systematic reviews to obtain studies for inclusion in their NMA. Based on the AMSTAR tool, almost half of the NMAs incorporated quality appraisal results to formulate conclusions, 36% assessed publication bias, and 16% reported the source of funding. Based on the ISPOR tool, half of the NMAs did not report if an assessment for consistency was conducted or whether they accounted for inconsistency when present. Only 13% reported heterogeneity assumptions for the random-effects model.Conclusions: The knowledge synthesis methods and analytical process for NMAs are poorly reported and need improvement. [ABSTRACT FROM AUTHOR]

Introduction: Economic evaluations conducted in children have unique features compared to adults. Important developments in pediatric economic evaluation in recent years include new options for valuing health states for cost-utility analysis (CUA) and shifting child health priorities. The Pediatric Economic Database Evaluation (PEDE) project includes a comprehensive database of pediatric health economic evaluations published since 1980. The objective of this scoping review was to identify trends over time in the use of CUA and other analytic techniques, and the therapeutic areas chosen for study. Areas covered: Medical and grey literature were searched, key characteristics were extracted, frequencies were tabulated and cross-tabulations were performed. Differences between early (1980 and 1999) and late (2000 and 2014) periods were assessed using a chi-squared statistic. Of the 2,776 pediatric economic evaluations published between 1980 and 2014, substantially more were cost-effectiveness analyses (CEAs) and CUAs than cost benefit analyses and cost minimization analyses (63.9 and 24.9% versus 7.6 and 3.6%, respectively). This pattern was consistent regardless of the type of intervention, disease or age group studied. A trend toward higher proportions of CUAs and CEAs was evident in the later period (X2 p < 0.0001). Other significant trends included a higher proportion of studies of preventive interventions (X2 p < 0.0001), and more studies in children aged 1 to 12 years and fewer in perinates in the later period (X2 p < 0.0001). Overall the most common disease class studied was infectious diseases (29.2%). Expert commentary: Pediatric economic evaluation continues to grow in volume and methodologic complexity. While CUAs have increased, whether their quality has improved remains unknown. Although most studies are in infectious disease, the volume of publications may not align with emerging child health priorities such as adolescent health, injury, developmental disabilities, mental health, and the use of personalized medicine. Increasing economic evaluations in these areas will enhance pediatric decision-making. [ABSTRACT FROM AUTHOR]

Objectives: To systematically review health economic guidelines for information on how to present health economic evaluations and consider implications for nontechnical audiences such as policymakers.Methods: Electronic databases and supplementary sources were searched for economic evaluation guidelines. Guidelines were critically appraised. Descriptive characteristics, standard formats, supports for nontechnical audiences, presentation approaches, and common reporting recommendations were extracted. Frequencies were tabulated and trends identified.Results: Thirty-one guidelines were included. Twenty-two guidelines include a standard reporting format with some sample tables and graphs. Common presentation approaches include well-cited tables of data sources, transparent model diagrams and descriptions, disaggregated results, and tabular and graphical displays of sensitivity analyses. Despite most guidelines being funded by policymakers, only five guidelines provided advice on presenting economic evaluations to noneconomists. However, 11 guidelines included a glossary of economic terminology for nontechnical readers. Common concepts that may require further explanation include differences in economic perspectives, appropriateness of time horizons, how economic outcomes such as quality-adjusted life-years relate to their component clinical outcomes, and choice of sensitivity analyses.Conclusions: Health economists have consistent presentation formats and common reporting elements that should be considered when developing user-friendly explanations for general audiences. These overlap with policymakers' informational needs but may not be sufficient for understanding by nontechnical audiences. Developing presentation formats and tools that incorporate viewpoints of both economists and noneconomists will allow for better application of the results of economic evaluations and enhance the transparency and legitimacy of decision-making processes that are informed by economic evaluations. [ABSTRACT FROM AUTHOR]

Introduction: Network meta-analyses (NMAs) are complex methodological approaches that may be challenging for non-technical end-users, such as policymakers and clinicians, to understand. Consideration should be given to identifying optimal approaches to presenting NMAs that help clarify analyses. It is unclear what guidance researchers currently have on how to present and tailor NMAs to different end-users. Methods: A systematic review of NMA guidelines was conducted to identify guidance on how to present NMAs. Electronic databases and supplementary sources were searched for NMA guidelines. Presentation format details related to sample formats, target audiences, data sources, analysis methods and results were extracted and frequencies tabulated. Guideline quality was assessed following criteria developed for clinical practice guidelines. Results: Seven guidelines were included. Current guidelines focus on how to conduct NMAs but provide limited guidance to researchers on how to best present analyses to different end-users. None of the guidelines provided reporting templates. Few guidelines provided advice on tailoring presentations to different end-users, such as policymakers. Available guidance on presentation formats focused on evidence networks, characteristics of individual trials, comparisons between direct and indirect estimates and assumptions of heterogeneity and/or inconsistency. Some guidelines also provided examples of figures and tables that could be used to present information. Conclusions: Limited guidance exists for researchers on how best to present NMAs in an accessible format, especially for non-technical end-users such as policymakers and clinicians. NMA guidelines may require further integration with end-users' needs, when NMAs are used to support healthcare policy and practice decisions. Developing presentation formats that enhance understanding and accessibility of NMAs could also enhance the transparency and legitimacy of decisions informed by NMAs. [ABSTRACT FROM AUTHOR]

A correction to the article "Characteristics and knowledge synthesis approach for 456 network meta-analyses: A scoping review" by Wasifa Zarin and colleagues which was published online on March 14, 2017 is presented.